Early exchange enrollment tilting toward Medicaid

Many of the early enrollees through the state-operated health insurance exchanges are applying for Medicaid coverage, Kaiser Health News reported.

Such a trend could hit hospital bottom lines, as the Medicaid program tends to offer the lower reimbursements for inpatient care than any other payer. However, officials noted that they expect to count more commercial plan enrollees in the near future. But commercial plans sold through the exchanges have catches of their own, such as lower reimbursement rates than coverage sold outside of the exchange.

In Washington State, as many as 30,000 of its exchange's first 35,000 applicants have entered the Medicaid program.

"We believe the reason we are seeing the higher Medicaid numbers is many people [buying private health plans] will wait until the last minute to pay for their health coverage like many of us do with our cell phone or cable bill," Bethany Frey, spokeswoman for the Washington state marketplace, told Kaiser Health News. Premiums are due Dec. 15 for coverage to be effective on Jan. 1.

In Kentucky, about two-thirds of early enrollees are eligible for Medicaid coverage. And in West Virginia and South Carolina, where Medicaid enrollment is being handled through a website separate from their federally-operated exchanges, enrollment is also heavy, according to Kaiser Health News.

Officials in all three states indicated that they expect the number of official commercial enrollees to rise as the first premiums come due.

To learn more:
- read the Kaiser Health News article

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